HomeMy WebLinkAboutPermit Building 1995-4-24
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
><'ASSESSORS MAP:
'(LOT: 11 I
--
SPRINGFIELD
~~
BLOCK'
OWNER: ~ (>a.,J - i\"'::L fL
ADD~E7A' (-)4( ))3, >rP ~ \r\ I J, \~)l Qu )
CITY~\)~ t MJ.Q."\ ~ (\J ~\ STATE:
~.~. \<()LJ\c\.QJ\(\Q
DESCRIBE WORt<'
NEW IY
REMODEL
.
JOB NUMBER
92J~/c
, PHONE:
y t:t to .rfl1- 4-
(U~
ADDITION
DEMOLISH
OTHER
ZIP:
Cfl4-l,
CONTRACTOR~AMt:' I ADDRESS
GENERAL: {l YtZc e, /l~e.r
PLUMBING' (ld71/ r j""", J pi/.,/
MECHANICAL: ~yt/ec., J.. _<)r>-rIl
ELECTRICAL' ~)- e lee.,
CONST.
CONTRACTOR N
97"''11
\ ()\~o14
!")n~dM
PAl 3=\
EXPIRES PHONE
?-Zt5>"1~ 5'~.>-?.1H'
[j.{S.qs 9~L/-/J~
6).a-\oqlo '14~l1ol7
\~. n.qln loKK3'i1()
-7
t
\Q~'l0 - OFFICE USE -
QUAD AREA- LAND USE: \ \ \ \ FLOOD PLAIN'
N OF BLDGS' - \ N OF UNITS: \ ZONING CODE: ll)~
OCCY GROUP: 'ft?'\'\ tJ\. CONSTR. TYPE: -1L,AJ N OF BDRMS: -~ '-
N OF STORIES' \ HEAT SOURCE: t:' F____ SECONDARY HEAT: Qf
WATER HEATER: C:- RANGF' F~ SOUARE FOOTAGE: \~
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, All Inspections requested belore 7:00 a,m, will be
made the same working day, InspectIons requested after 7:00 a.m. will be made the following work day.
~ Temporary Eloctrlc
D Site Inspoctlon - To be made
after excavation, but prior to
settfng forms.
D Underslab Plumblng/Electricall
Mechanical - PrIor to cover.
KA'" Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting,
~oundatlon - After forms are
~erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
1V'I7underfio~lumb~echa~
~ - Prior \v IflSulatlon or decking.
"f'7f Post and Beam - PrIor to tloor
~lnsulBtlon or decking.
~ Floor Insulation - Prior to
~decklng,
lVl Sanitary Sewer - Prior to filling
~ trench.
~Storm Sewer - PrIor to filling
~ trench.
1'Jr Water Line - Prior to filling
~ trench,
-t:::Ir Rough Plumbing - Prior to
~cover.
REQUIRED INSPECTIONS
f'::/( Rough Mechanical - Prior to
~ cover.
~ Rough Electrical - Prior to
~ cover.
'l"V1 Electrical Service - Must be
~ approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
JZ(Framlng - Prior to cover.
'K7f' WafiI C'elllng Insulation - Prior to
J.AJ cover.
~ Drywall - Prior to taping,
D Wood Stovo - After Installation.
D Insert - After fIreplace approval
and Installation of unit.
'f:;;;7f Curbcut & Approach - After
~forms are erected but prior to
placemont of concrete.
f)('( Sidewalk & Driveway - Afler
~excavatlon Is complete, forms
and sub.base material In place.
D Fence - When completed.
~treet Trees - When all required
~trees are planted.
I"Qf Final Plumbing - When all
~ plumbing work is complete.
l'5?f Final Electrical - When all
~ electrical work Is complete.
lV'fFlnal Mechanical - When all
~ mechanical work Is complete.
~Flnal Building - When all
~requlred Inspections have been
approved and building Is
completed,
.",,,-
D Othor il'l/~""ty\,/c.-/v "'''.,\co;~/d~J
~~A tl('(J)..p:&J
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Final - Alter all required
inspections are approved and
porchos, skirting, decks, and'
ventIng have been Installed.
Setbacks
I P.L, I HSE GAR I ACC i
IN I e I
Is I /~ I/~ I
w I
Lot 'aces ~
Lot sq, ltg, ?FJ?O
Lot coverage ..12.a.S?
Topography ~.z!b
Total height ~5
( 8':,
Lot TYP.
Vlnterlor
Corner
Panhandle
Cul.de.sac
E
BUILDING PERMIT
SQ, FT,
j5Z,-L
42.C;
ITEM
X $/SQ, FT,
S"'t:. ~ P
---,-~/D
VALUE
~~JO.1o
" -5 5'n ..sa
MaIn
Garage
Carport
Tolal Value
.
~_ZPJ~O-O
'L1<.\9. .W
...~.C\lo
444%
Building Permit Fee
State Surcharge -t ~
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) ,j.,
(B) {/; '2-1c'a'if ~ 'f'P
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ~
Sanitary Sewer FT,
Water FT,
Storm Sewer FT.
Mobile Home
J1()() ~
Plumbing Permit
1/ oO.CO
B
(0 CO
4.s0
l. (X)
n.
Stale Surcharge
-t 39'0
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood StoveJlnsertlFlreplace Unit
Dryer Vent
'J...W
'- ).
Mechanical Permit
19.~
I(),O{J
f. ,c::a
3f,(jfl
Issuance
State Surcharge ~::~e6
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
Slale Issuance
State Surcharge
Sidewalk 1LP. (t
Curbcut 3 ~ It
~\V
14.9{)
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrICal)dffi.-:,(~
lA, B, C, D, and' E' Combined)
. " :.',~':.
'IS THE PROPOSED WORK IN THE.
''''HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
If yes, this apptication must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
12:>
APPROVED: ,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Springfield, Including the
Development Code. regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: 2h? So
Date Paid: _ ~/JO/'7'-
Receipt Number: I~-f- /~
Recel~~Po/~~~~
P~~ By #~S"
Systems Development Charge is due on all undeveloped
properlles within the City limits which are being Improved,
ADDITIONAL COMMENTS
,
\. ~ 1 ~ 0 I( ('1 c-oCl. (\ a l\ \;:"
I
~\- T: W Jlll Q.& f'J\\\ Xl )
\ctl\l\tl" \QQS? l\
(' l1tiJ1J1c1 Q_ ~)(c1 tLLX1J1L/
iIo t1~A-LJ!: .r~~
GaW~~J UAJT// J< "'~
IS ~7SJ) A#( #UAVC; ~~rr,
I
By signature, I state and agree, that I have carefully examined
the completed applicatIon and do hereby certlfy that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thai NO OCCUPANCY wilt be made 01 any
structure without permissIon of the Building Safety Division.
I further certify that only contractors and employees Who
are In compliance with ORS 701,055 will b'e used on this
project,
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card is located at the front
of the properly. and the approve sel of plans will remain
on the Sltb~, urin onstructlon,
~nature ........,
Datp 7' ~ ;;, r ~ 9-...)
VALIDATION: ~
RECEIPT NUMBER . \ lO I \
DATE PAIr> 4',M ,y~
AMOUNT RECEI~E~ '0M \ -[1:)
RECEIVED BY 1"'T\ IJ~
~ ,
.
.B NO. Cf'5 04-1 b
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: S'1' CAN {3
LOCATION: 04-q N / c..H 0 LAS "OIV VE
DEVELOPMENT TYPE: L D t<. - N E-IN SI"-F<.
/,03'2'2./7- -OI~()"
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
'Z? '2-0
X $0.209 PER SQ. FT. EZb "0
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
I~
X $43.26 PER PFU
E78bi)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
I X / , 0 I X $436.19
X
X
X $436.19
X $436.19
cC~s~
$
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S f~ x $17.19 PER PFU + $10 MWMC AOM FEE
(Use PFU Total From Item 2 Above)
$ ?, "I 4-2.
TOTAL-MWMC SDC
SUBTOTAL (ADO ITEMS 1,2,3 & 4)
$ Ai.A.
~
----
$ "2-61\,5'?>~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE)
k1'_~~L~
. - -d"Ki p Burdick
SDC Coordinator
X .05
Date: ~ /"';, I l<ft;
,
TOTAL SDC
G/03Z:t)
............ ......-
$ 2/ (" <i' 6~
FIXTURE UNIT CALCULA1i6QN TABLE: Number of New Fixture... Unit Equivalent =' Fixture Units
(NOTE: For remodels; calculate only t~ additional fixtures) .
, NUMBER OF UNIT FIXTURE "
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
I
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
"2.
Bathtub........ ..... ............................'... ............ ...... .......
Drinking Fountain.....................................................
Floor Drain.....................,...,......................................
Interceptors For Greasc/Oil/Solids/Etc,........,.......
Interceptors 'For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher...................................
Clotheswash.er ,.3 Or Mpre.,...,................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Roceptor For Commercia' Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang.............. ...... ............ ... ..... .... .......:,.....
Sink: Bar, Commercial. Residential Kitchen..............:.........
Urinal, Stall/Wall......... ....... ............................. ...........
Wash Basin/Lavatory. Single..................................
Toilet, Public Installation........................................
Toilet. Private..................................................:,...
Miscellaneous:
/
'1-
'l-
'2..
2..
'2-
7....
'6
TOTAL FIXTURE UNITS
=
/8
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table.
calculate credits separates,
Year
Annexed
Hate per $1,000
Assessed Value
Year
Annexed
Hate per $1,000
Assessed Value
-1
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
~
Improvement (if after annexation date)
X $
(Rate X Assessed Valuel
X $
(Rate X Assessed Valuel
=
-ft-
Credit for Parcol or Land Only If Applicable
=
CREDIT TOTAL = $ N.4.
"
.
SPRI"ELD
The following projacl a9 submitted has the fa
zoning, and does not require specific land us
225 FIFTH STREET approval. ELECTRICAL PERMIT APPI.TCATION
SPRINGFIELD, OREGON 97477 Zoning '~DL () hf'vLI t
INSPECTION REQUEST: 726-37~9 4-7 L..J -c-,<r Ci ty Job Number -1,- J-LJI (J
OFFICE: 726-3759 me ~I
Autho 3.A. J AfIIIPLETE FEE SCHEDULE BELOII
1. t.~~\~"~Y~N
\ ~~'rJ~N () \ 2D LD
6~B"6CP;ryION \qaq '(!)
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2, vu,'u-.ACTOR INSTALLATION ONLY
"-
Electrical Contractor "\P(\IN'~ rle.,Jp,;L
. Address III ~o GHJ~\f 1'3k\ \)~ :l\-1lI
City' fv..l"'W" Phone r;gB'3010
Supervisor Licen.se Number i~ 1'1 5
Expiration Date ID'I - '\S
.,
"
Constr Contr. Number x"\l :VT'"
Expiration Date ~ - 11 . 'V-I
Signature of Supervising Electrician
~-{L
Owners Name~1.tf) 1\: B _ D,
Addresss~40a.Jcl[Jf}au (J{W
City 9fJitrJ Phone ~b '<01ft
O\INER ~NkTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~--------~-~-<:f:m- C{::J ------
RECEIPT t: \. Q . _ _ I~
RECEIVED BY:("-../ l) \J )()( )
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
uni t.
Cost Sum
$ 85.00 fu
$ 15.00 .3()
$ 40.00
Items
1000 sq.ft. or less 1
Each additional 500
sq. ft or portion /)
thereof ()I
Each Manuf' d Home or .
Modular Dwelling
Service or Feeder
B,
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C,
Temporary Services or'Feeders
Installation, Alteration or Relocation
l $ 40.00 ~~
$ 55.00
$ 80.00
volts see "B" above
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.06.
$ 2.00
E,
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
4OpO
&,Cx:J
I . cJ.q
'- 'I
1-3 ,,JV
not included)
5.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
II~..~
h.'" "'"
1d-.4. .;16
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
.
.
.
~ y!i!I~,!!!~!~~~
Job No. q~lo
f\~ '
lqCATION OF PROPOSED Bp~ SI\6\ .. ^ fh. I "-' f\. ' '
. Street Address if Known: ~ \ l \ \. ~ \()\ll tLt \...-\Jt\ l ~ ..>
Plan ~()\l\.D \)mc~ Tax lot Number. flJ~a\ ~()\?fi~
SYSTEMS DEVElOPMENT CHARGE
WORKSHEET
ADDRESS: ,
PHONE: '"1\\0 .001-
STATE~ ZIP C{WJ.
1. DEVELOPMENT TYPE (Check appropriate dwelling(sl. SDC Calculations and dwelling type
definitions are on the back.l
A. Sinl!le family - Detached
I Single Family home
NO OF UNITS I
B. Sinl!le familv - Attached
NO OF UNITS
C. Multi-familv Aoartment
NO OF UNITS
D. Manufactured Home Park.
NO OF UNITS
Manufactured home not in a park ,.A N~ (JJ
X $400 PER UNIT _=,. $ ,.~, .
.
X $370 PER UNIT =
'$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
. $4lYJ,cV
$';;/
$ 4rfjJJ
WPRD SDC
2. SDC CREDIT (If applicablel SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl
i~~.L!~~eJ
4- 1M I~S
Date
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